 Thank you, Maureen, and we'll go now to the designated reactor, and it'll be Wendy Chun. Hi, can everyone hear me? We can. Okay, very good. So, next slide, please. So, I think one of the things that's emerged over the discussion this morning and this afternoon is that Emerge 3 may be at a point of some changing in terms of information that may be obtained in terms of sequencing and potentially decisions to be made in terms of what information will be returned to participants. So, just some thoughts in terms of thinking about how that may change over time and realizing that the next section will be on return of results and so not wanting to seal that thunder. I think the research community, when we think about samples that have been collected before the area when they were consented specifically with the idea of doing these comprehensive exomer genome sequencing, I think I'm going to bring up a couple points to this, but I think one of the things the community has realized is that there's no single correct solution in terms of approaching the things that I'm going to talk about. And so, just because Emerge has so many different sites and some of the issues may be site-specific, while hopefully there will be consensus and common methods of consenting, educating the community, I just encourage everyone to realize that there's not necessarily going to be one standard answer that absolutely every site must fit. And so, just realizing that local community representatives, local IRBs may have issues with this, hopefully there can be some guidance in terms of Emerge in terms of governance overall, but I think to realize that there may be local issues is important to understand and to acknowledge. One of the things, at Columbia we've actually done some surveys of the research community both in terms of online surveys as well as semi-structured interviews, and as we've done that, trying to think about the issues specifically of samples that were collected before this genomic era of whole exome genome sequencing and what to do about return of both incidental findings as well as return of individual research results. One of the major issues that came out of surveying the research community, over 250 researchers, was that there seems to be quite a bit of variability between the IRBs. Variability both in terms of knowledge and expertise around genomic issues and quite a bit of education that needs to be done, and what we are hearing recurrently is that the same issue, different IRBs would in fact have different rulings on this, and that these issues hadn't been specifically addressed in the original consent form, that it was very dependent upon local IRBs, their composition, their understanding of this information. And so, just in reflecting in a position where Emerge 3 may be, I hope that it's an opportunity to study that process, in fact, to gain some experience and some understanding about what may lead to some of these local differences, as well as potentially the opportunity to develop centrally materials to educate or materials to be able to explain this to IRBs, because where there should be more consensus is building, hopefully it's not just simply doing this understanding of simple sort of medical and genetic issues in terms of this. So I think that's something that if Emerge is able to do that, it's a broader issue across the research community in terms of how to deal with this, and in fact, just because there will be 10 sites to be able to do this across, could provide some really useful information in terms of a larger community. Next slide. So in terms of consent, one of the issues with consenting has been across many smaller studies, that again, consents largely didn't address some of the issues that may start to emerge. And so, thinking about this and thinking that there may be different ways of dealing with the consent, there's, again, I just urge people to think about there may not be one size that fits all for this. Clearly, just over time, what participants may have been expecting may have changed, so that when many of the Emerge participants original and consented, they, nor we, I think, were thinking about some of the things that are possible to know from the genomic information. And so they, although they may have signed a very broad sweeping consent, may not have thought about some of the details about what's now possible to be returned to them. And so, again, thinking about how to educate the community about that, either retrospectively on prior consent to patients or prospectively on newly consented patients, really is going to take some creative ways of educating the community about this. So, many people have thought about how to be able to approach this and the standard written consent, unfortunately, is not the most effective way of educating our participants. And so one of the things that many people have thought about doing is having either video educational materials or online resources. Things that participants, you know, can be able to go back to with the online resources, be able to take deeper dives even potentially and be able to go back to it iteratively over time, not even, you know, speak with other family members or other valued sources, physicians or other health care providers to gain more information. But that material can be very useful. And one of the things that we've learned in doing that process is that it needs to be very accessible and that some of the very complicated things that we'll do on a genetic counseling session, for instance, may not be what you would want to include in one of these very broad educational sessions when talking probably about different types of results that could be returned. And again, it is possible, especially with this online education, to provide deeper layers for individuals who really want to get into it. But realizing that many of our research participants, if we give them all that information up front, don't even, they literally tune out, they get saturated by this information and really can't absorb a lot of the critical details and want to know it more on a need-to-know basis when it's something that's relevant to them and then dive much deeper when they know that it's something that they really need to pay attention to and tune into. So in thinking about that, some of the different groups have thought about a staged consenting process or a staged information process. That is the original time one participant's consent may not be the time to overwhelm them to follow this information, but it's more on a need-to-know basis. And so as it comes the opportunity in terms of being able to think about return of particular results or situations that may arise, being able to then give more relevant information at a time that's proximal to when that's relevant to them. This also can be an issue for participants who have been enrolled many, many years ago, just in terms of their life stage, what's happened to them over life, their preferences may in fact have changed over that time period. And so it may be relevant for them to rethink these issues at a proximal time to when it might be relevant to them. One of the wonderful things about Emerge, of course, is by many of the patient portals that are available, that actually provides a lot of the infrastructure to be able to do that. And it's something that, again, as we've talked to the larger research community, many researchers wish they had that as part of what they could do to more easily streamline in terms of recontacting and re-educating participants. I will say the one pushback we've heard from the research community about this idea of a staged consent however is that it may actually alert research participants if they feel as if they've been singled out during that process to alert them that there may be something that's sort of lingering or something that they should be worried about. And so as individual sites think about governance and how they might do this to just keep that in mind on whether they're going to do this in terms of a community-wide effort or whether they're going to target or single out individuals who might have specific information be returned to them. Next slide. So I'm, again, going to try and focus on the LC issues in terms of the return of results rather than the next group they'll speak more broadly about this. But again, these can be very complicated and depending on whether or not this is done all up front at the consent initially or in a staged manner, the issues can be quite complicated but it is, in our opinion, sort of necessary to be able to make these as streamlined and simple and sort of broad sweeping in terms of concepts rather than getting into too much of the nitty-gritty. One of the issues that has come across a merge because of the addition of the pediatric population and, again, because it's gone on now for several years is that there are special populations in certain situations that just naturally changed over time. So there are special issues when it comes to minors and what information and what sort of ability they have to provide their assent into being able to have any information provided back to them and, of course, developmentally, those children may change over time so that in a long period of time they may be minors in the study and they may be of maturity later within that study and need to potentially go back and re-consent those individuals and, clearly, the pediatric side took them thinking about this. In addition, individuals may actually have differences even in their vital status. There may be individuals, obviously, who are deceased over time but that information could still be potentially quite important to other family members for hereditary conditions and so trying to incorporate and think about that in terms of the consenting process for return of results would be important to do as well as individuals that may lose cognitive capacity over time again thinking about a healthcare proxy who might have a vested interest in that information and how that might influence in terms of information being returned. Another issue that frequently comes up is with such large biobanks, obviously there are many, many different users of that information and in terms of governance realizing that many of those secondary users may not feel the same sense of obligation in terms of annotating or returning that information in a detailed way and so individual governance at each of the sites will be important in terms of being able to coordinate return of that or annotation cataloging in detailed ways from some researchers who are in fact quite expert in terms of understanding that but may not necessarily be motivated in terms of prioritizing for that return that will be important for the central sites to be able to do. If I could just go back, I think I didn't quite finish with that slide. Thanks very much. And then an issue that will be coming up as again you make some decisions in terms of what sequencing to do, again we discussed the ACMG guidelines in terms of mandatory return of results that will be I'm sure a very hot area of discussion with an emerge to try and decide whether or not to what to do in terms of that policy but just to realize that again I would urge to realize that the clinical requirement that we have in terms of return of that results may not be necessarily what gets adopted in terms of return of research results within that. Again it's already been mentioned but just to emphasize there's a tremendous opportunity to be able to educate providers sort of on demand with the info buttons and other information and really to just emphasize that I think Emerge has a tremendous opportunity here in terms of implementation to be able to figure out best practices and essentially disseminate that throughout the rest of the clinical community because I do think you're going to have the ability within different EHR systems to be able to figure out what works and that really is going to be tremendously valuable to others. Next slide. And I'll just wrap up by saying that being able to do this is really invaluable to Emerge and it's clearly what many of the rest of those of us outside of Emerge would find useful and to be able to just as you're thinking about doing all of these things to be able to collect data on the process as you're going through and to learn from this I think is going to be tremendously valuable and to realize that there may be some as well regulatory issues that come up. Clearly the FDA is starting to think about how to regulate some of these and so there may be things that will come up as obstacles but hopefully not barriers in terms of implementation. I think that's my last slide. So now we'll go on to read Pirates for the summary.